Consultants in Pain Medicine, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

CONSULTANTS IN PAIN MEDICINE, LLC

Practice address

1218 Alice St
Waycross, GA 31501-4525

Phone

(912) 590-0973

Fax

(912) 590-0180

NPI assigned

Apr 10, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alicia M Groth

Title

Credentialing Manager

Phone

(904) 223-3321

Specialties & licenses 1

Addresses

Other names 1

• Centurion Spine & Pain Centers Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Statesboro, GA
  • NPI 1356118020

  7911975248

  Same PAC ID
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Pooler, GA
  • NPI 1568121846

  7911975248

  Same PAC ID
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Brunswick, GA
  • NPI 1902852130

  7911975248

  Same PAC ID
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Savannah, GA
  • NPI 1942052022

  7911975248

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Consultants in Pain Medicinellc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Richmond Hill, GA
  • NPI 1104775600
  NPD tax ID
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Statesboro, GA
  • NPI 1356118020
  NPD tax ID
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Pooler, GA
  • NPI 1568121846
  NPD tax ID
• Consultants in Pain Medicine, LLC

  • Interventional Pain Medicine Physician
  • Savannah, GA
  • NPI 1942052022
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1497440911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-256-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014525",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTANTS IN PAIN MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "GROTH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "904-223-3321"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centurion Spine & Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cole Vision Corporation
• Jamie Coleman, FNP-BC
• Columbus Medical Services
• Concerted Services, Inc.
• Consultants in Pain Medicine, LLC
• Emma Cook, RD
• Laneshia Natoria Cooper, LCSW
• Linda Howard Cooper, BA APPLIED BEHAVIORA
• Kristi Lucas Corbett, CCC-SLP
• Adam Ransford Corman, MD

• Interventional Pain Medicine Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.